| Travis Booth Lcpc, Inc. | |
|
1531 S Grove Ave Unit 204 Barrington IL 60010-5251 | |
| (847) 381-2700 | |
| (847) 381-2722 |
| Full Name | Travis Booth Lcpc, Inc. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1531 S Grove Ave Unit 204, Barrington, Illinois |
| Authorized Official Name and Position | Travis Andrew Booth (PRESIDENT) |
| Authorized Official Contact | 8473812700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Travis Booth Lcpc, Inc. 1531 S Grove Ave Unit 204 Barrington IL 60010-5251 Ph: (847) 381-2700 | Travis Booth Lcpc, Inc. 1531 S Grove Ave Unit 204 Barrington IL 60010-5251 Ph: (847) 381-2700 |
| NPI Number | 1023460763 |
|---|---|
| Provider Enumeration Date | 07/06/2016 |
| Last Update Date | 07/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023460763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 060.011815 (Illinois) | Primary |
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